[Clinical and psychopathological features of treatment-resistant schizophrenia].

Abstract

Objective: To study the psychopathological structure of resistant schizophrenia with the distinguishing of various clinical variants.

Material and methods: The study was conducted at emergency departments of the round-the-clock Psychiatric Clinical Hospital No.1, named after N.A. Alekseev. One hundred twelve patients with a diagnosis of schizophrenia were examined using clinical psychopathological and psychometric methods as standardized scales (PANSS and BFCRS).

Results: Three clinical variants have been identified: impaired reasoning and perception with a predominance of delusional disorders, catatonic disorders with a predominance of oneiroid confusion, and impaired behavior and affect with a predominance of aggression. The earliest onset age of 17.1±3.2 years was found in the clinical variant with behavioral impairment (p=0.022). In the clinical variant with impaired reasoning, there were statistically significant differences (p<0.05) in the sum of scores on the PANSS-P subscale - 31.7±3.1; on P1 «Delusions» - 6.5±0.6; P2 «Conceptual disorganization» - 5.9±1.6; P3 «Hallucinations» - 6±0.3; G4 «Tension» - 5.5±0.6; G9 «Unusual thought content» - 5±0.8.

Conclusion: The study of resistant schizophrenia with the identification of disorders in various areas of mental activity and the determination of their quantitative indicators is a promising area of research, as it helps to identify risk groups for the development of resistance and develop new strategies for overcoming it.